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Prior Authorization Coordinator Jobs (NOW HIRING)

Phoenix Heart

Authorization Coordinator

Glendale, AZ · On-site

$16.75 - $20.75/hr

The Authorization Coordinator secures prior authorization for diagnostic tests, verifies insurance eligibility, and benefits and checks for certain medical necessity requirements prior to the patient ...

BrightSpring

Prior Authorization Specialist

Louisville, KY

$16.50 - $22/hr

The Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility ...

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How much do prior authorization coordinator jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for prior authorization coordinator in the United States is $21.32, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $22.12 per hour, depending on experience, location, and employer.

What is a prior authorization coordinator?

Prior Authorization Coordinators are healthcare professionals responsible for managing and obtaining approval from insurance companies before certain medical services, procedures, or medications are provided to patients. Their main duties include reviewing patient information, communicating with healthcare providers and insurers, and ensuring all necessary documentation is submitted for timely authorization. They play a crucial role in reducing delays in care and helping patients navigate complex insurance requirements. Strong communication, attention to detail, and knowledge of insurance processes are essential skills for this role.

What are the key skills and qualifications needed to thrive as a prior authorization coordinator?

To thrive as a Prior Authorization Coordinator, you need strong knowledge of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or a related certification. Familiarity with electronic health records (EHR), insurance portals, and prior authorization management systems is typically required. Attention to detail, organizational skills, and effective communication are essential soft skills for efficiently handling authorization requests and collaborating with providers and insurers. These skills ensure timely approvals, minimize claim denials, and support smooth patient access to prescribed care.

What are some common challenges faced by prior authorization coordinators, and how can they be managed effectively?

Prior Authorization Coordinators often encounter challenges such as navigating complex insurance requirements, keeping up with frequent policy changes, and managing high volumes of requests. To handle these effectively, coordinators need strong organizational skills, attention to detail, and the ability to communicate clearly with both healthcare providers and insurance representatives. Staying updated on payer guidelines and using electronic health record (EHR) systems efficiently can also streamline the process and reduce delays in patient care.

What is the difference between Prior Authorization Coordinator vs Medical Billing Specialist?

AspectPrior Authorization CoordinatorMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like CPC or CPC-HRequires coding certifications (CPC, CCS) and knowledge of billing procedures
Work EnvironmentHealthcare facilities, insurance companies, or billing companiesMedical offices, hospitals, or billing companies
Employer & Industry UsageUsed in healthcare settings to manage insurance approvalsUsed across healthcare to process and submit claims
Search & Comparison IntentPeople compare roles related to insurance approval processesPeople compare roles related to billing and claims processing

The Prior Authorization Coordinator focuses on obtaining insurance approvals before treatment, ensuring coverage compliance. In contrast, the Medical Billing Specialist handles submitting claims and processing payments after services are rendered. Both roles are essential in healthcare administration but differ in their primary functions and workflows.

Is prior authorization a stressful job?

Prior Authorization Coordinators often experience stress due to tight deadlines, the need for accuracy, and managing complex insurance requirements. The role requires attention to detail, communication skills, and familiarity with medical policies, which can contribute to job pressure but also offers a structured workflow to handle tasks efficiently.
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Prior Authorization Coordinator jobs near you
Infographic showing various Prior Authorization Coordinator job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $44,339 per year, or $21.3 per hour.

Lead Pharmacy Prior Authorization Coordinator

BrightSpring

Louisville, KY

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

BrightSpring Health Services rating

4.9

Company rating: 4.9 out of 10

Based on 65 frontline employees who took The Breakroom Quiz

224th of 247 rated social care providers

Job description

Our Company
PharMerica
Overview
Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!
Schedule: Mon-Fri(8:30am to 5pm)
This is a hybrid opportunity. Applicants must reside in, or commutable distance, to Louisville, KY
We offer:
DailyPay
Flexible schedules
Competitive pay
Shift differential
Health, dental, vision and life insurance benefits
Company paid STD and LTD
Tuition Assistance
Employee Discount Program
401k
Paid-time off
Tuition reimbursement
Non-retail/Closed-door environment
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
*Position will be posted for a minimum of 7 business days
Responsibilities
The Pharmacy Lead Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or coordinating with prescribers and/or facility contacts to have therapy changed to a preferred alternative due to insurance not covering the treatment in question. The Pharmacy Lead PA Coordinator also oversees new hire training completed by the Prior Authorization Coordinator II.
  • Helps manage staff appropriately and sets clear expectations for performance
  • Works with Billing Coordinator/Supervisor/Manager in researching pharmacy accounts requiring special attention
  • Assists Billing Coordinator/Supervisor/Manager in overseeing daily prior authorization activities per policies and procedures when necessary
  • Ensures appropriate, timely and professional communications occurs with Implementation team, Account Management team, Directors of Pharmacy, and Facility staff as needed
  • Audits prior authorization functions regularly for compliance to policies, procedures, contract and government regulations
  • Prioritizes and delegates job tasks to ensure timely completion
  • Follows all applicable government regulations including HIPAA
  • Participates in projects and/or management meetings
  • Addresses workflow and/or business issues while keeping direct manager informed
  • Participates on various prior authorization specific sub-groups to identify all attributes for best practice implementation and influences development of policies and procedures as well as identifies appropriate training material and educational opportunities
  • Implements proper prior authorization forms and forwards them to physicians to obtain approval
  • Completes change of therapy forms to facility contacts and physicians
  • Adjudicates claims, researching formularies for numerous insurance plans, contacting physician's office, updating spreadsheets on a daily basis, follow-up and obtain approval or denial of prior authorizations
  • Communicates timely and in a courteous manner to the physician/clinical staff regarding authorization status or delays
  • Oversees and approves updates made to the Prior Authorization Training Manuals by the Pharmacy Prior Authorization Coordinator II

Qualifications
  • High School Diploma/GED required
  • Pharmacy Tech License preferred
  • Excellent customer service and communication skills, both written and verbal
  • Ability to prioritize and meet pre-determined deadlines
  • Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
  • Experience in healthcare billing environment (pharmacy preferred)
  • Familiarization with online claims processing and Medicaid and Medicare billing practices
  • Proficient with Microsoft Word & Excel required
  • If a current PAL employee, you must:
    • Have 6+ months of prior authorization experience as PAL Core Prior Authorization Coordinator
    • Adhere to Pharmacy Alternatives, LLC attendance policy
    • Excel and adhere to core Pharmacy Alternative Prior Authorization responsibilities
    • Not be on any form of Performance Improvement/Corrective Action Plan

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

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